Term
| what are The cardinal differences in depression, dementia, and delirium? |
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Definition
1 Onset of mental-status change and course of illness
2 Level of consciousness
3 Attention span |
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Term
| what is "The Silent Geriatric Giant.” |
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Definition
anxiety disorders in late life .
Older adults often have multiple physical complaints, medication problems, pain, sleep disturbances, as well as psychiatric illness. Anxiety is twice as prevalent as dementia, and four to eight times as common as major depressive disorders. |
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Term
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Definition
| Delirium occurs secondary to a general medical condition. It causes fluctuations in consciousness and changes in cognition which develop over a short period of time (hours to days). |
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Term
| what medications are often prescribed to combative/agitated patients with delirium? |
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Definition
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Term
| what medications are often avoided with combative/agitated patients with delirium? |
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Definition
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Term
| characteristics of Dementia |
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Definition
| characterized by aphasia (difficulty finding words), apraxia (difficulty carrying out motor functions despite intact functioning), agnosia (failure to recognize objects), and disturbances in executive functioning (organizing, planning, abstracting, insight, judgment) |
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Term
| describe sexual disinhibition as it relates to dementia patients |
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Definition
. Older patients may be overly flirtatious, grope caregivers or family during care, make sexually inappropriate comments, expose genitalia, or masturbate openly.
It is important for the nurse to be open and understanding about such behaviors and to recognize them as symptoms of a brain dysfunction (frontal lobe). |
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Term
| What are the names of the 2 alchohol screening tests that may be performed on older patients? |
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Definition
CAGE-AID screening tool.
the MAST-G. |
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Term
| what are the signs of alcohol abuse in the elderly? |
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Definition
| contusions, malnutrition, self-neglect, depression, and falls..Diarrhea, urinary incontinence, decreased functional status, failure to thrive, and apparent dementia may also be present |
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Term
| What does CAGE-AID stand for? |
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Definition
C—Have you ever felt you ought to Cut down on your drinking (drug use)?
A—Have people Annoyed you by criticizing your drinking (drug use)?
G—Have you ever felt bad or Guilty about your drinking (drug use)?
E—Have you ever had a drink (used drugs) first thing in the morning (Eye-opener) to steady your nerves or get rid of a hangover?
AID—Adapt to Include Drugs. One positive answer indicates a possible problem; two positive answers indicate a probable problem. |
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Term
| what are the 6 reccomended treatments for elderly drug/alcohol abusers... according to the Center for Substance Abuse Treatment |
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Definition
1 Age-specific group treatment that is supportive and nonconfrontational and aims to build or rebuild the patient's self-esteem
2 A focus on coping with depression, loneliness, and loss (e.g., death of spouse, retirement)
3 A focus on rebuilding the patient's social-support network
4 A pace and content of treatment appropriate for the older person
5 Staff members who are interested and experienced in working with older adults
6 Linkages with medical services, services for the aging, and institutional settings for referral into and out of treatment, as well as case management |
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Term
| what does (MAST-G) stand for? |
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Definition
| Michigan Alcoholism Screening Test—Geriatric Version |
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Term
| what are the 3 categories of depressive symptoms according to Jann and Slade (2007)?? |
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Definition
emotional (mood, motivation, apathy, anxiety),
cognitive (concentration, memory),
and physical (insomnia, fatigue, headache, and stomach, back, and neck pain). |
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Term
| what is the "Wong-Baker FACES Pain Rating Scale" |
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Definition
| active assessment instrument. The FACES scale shows facial expressions on a scale from 0 (a smile) to 5 (crying grimace). Respondents are asked to choose the face that depicts the pain they feel. |
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Term
| What was found to be the most useful instrument for pain assessment in nursing-home residents, including both the cognitively intact and the impaired. |
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Definition
| The present pain intensity (PPI) rating from the McGill Pain Questionnaire (MPQ) |
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Term
| what is the "present pain intensity" (PPI) rating from the McGill Pain Questionnaire (MPQ) |
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Definition
| another tool accepted for use with older patients. Patients are asked to respond by selecting the description (from “no pain” [0] to “excruciating pain” [5]) that they believe identifies the pain they feel |
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Term
| what is The Pain Assessment in Advanced Dementia (PAINAD) scale? |
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Definition
| It is used to evaluate the presence and severity of pain in patients with advanced dementia who no longer have the ability to communicate verbally (Figure 29-3). The scale evaluates five domains: breathing, negative vocalization, facial expression, body language, and consolability |
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Term
| Analgesics reach a higher peak and have a longer duration of action in older adults than in younger individuals. Start with ______ to______ the adult dose, and titrate up carefully. |
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Definition
| 1/4th to 1/2 the adult dose |
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Term
| which opiate should be avoided in the elderly since it may stimulate the central nervous system and lead to confusion, seizures, and mood alterations? |
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Definition
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Term
| Health care expenses for older adults are how much higher than the expenses for the rest of the population? |
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Definition
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Term
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Definition
| a bias against older people because of their age. It is based on erroneous beliefs that older adults are unattractive, unintelligent, asexual, unemployable, and senile |
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Term
| what is an advance directive? |
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Definition
| Such a directive indicates preferences for the types of medical care or amount of treatment desired. The directive comes into effect should physical or mental incapacitation prevent the patient from making health care decisions. |
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Term
| 3 types of advance directives |
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Definition
: (1) a living will,
(2) a directive to physician,
(3) a durable power of attorney for health care. |
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Term
| what is a psychiatric advance directive? |
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Definition
| those with serious mental illness can designate a health care agent to make treatment decisions during an illness relapse |
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Term
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Definition
| a personal statement of how and where one wishes to die (Ebersole et al., 2004). It is activated only when the person is terminally ill and incapacitated, and a competent patient may alter a living will at any time. |
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Term
| what is a directive to physician? |
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Definition
| a physician is appointed by the individual to serve as proxy. Many of the features of a directive to physician parallel those of a living will, such as activation only when a terminal illness is present, need for verification of the terminal illness by the physician, and requirement of patient competency at the time of signing. |
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Term
| what is the "durable power of attorney for health care"? |
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Definition
| a person other than a physician is appointed to act as the patient's agent. The patient must be competent and of age when making the appointment and must also be competent in order to revoke the power. Individuals do not have to be terminally ill or incompetent to allow the empowered individual to act on their behalf. |
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Term
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Definition
| an involuntary trust relationship in which one party, the guardian, acts on behalf of an individual, the ward. The law regards the ward as incapable of managing his or her own person and/or affairs. |
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Term
| what are the 3 common orders in advance directives? |
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Definition
1 Full code: All life saving measures are initiated.
2 Do not resuscitate–comfort care arrest (DNR–CCA): All life saving measures are initiated, except in the case of a full cardiac arrest and intubation.
3 Do not resuscitate–comfort care only (DNR–CCO): Medical care is focused on providing pain-free quality of life and comfort free of invasive procedures and intubation. |
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Term
| what are the major "biological" theories of aging? |
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Definition
• Gene theory: Harmful genes become active in later life.
• Error theory: Error in protein synthesis results in impaired cellular function.
• Free radical theory: Reactive molecules damage DNA.
• Wear-and-tear theory: Internal and external stressors harm cells.
• Programmed aging theory: Biological or genetic clock plays out on genes.
• Neuroendocrine theory: There is neurohormonal regulation of life until death.
• Immunological theory: Immune system diversifies with age. |
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Term
| what are the "psychological" theories of aging? |
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Definition
• Kohlberg's theory: Crises and turning points in adult life are moral dilemmas.
• Piaget's theory: Cognitive operations in youth influence aging.
• Erikson's theory: Integrity is built on morality and ethics.
• Bandura's theory: Self-efficacy is essential for longevity.
• Sullivan's theory: Interpersonal responses influence behavior.
• Freud's theory: Focuses on control of instinctual responses.
• Psychobiological theory: Neurotransmitters modulate behaviors, emotions, and thoughts.
• Dialectical theory: Crises and transitions release positive and negative forces that lead to developmental progress.
• Behavioral theory: Learning determines the organization of behavior. |
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Term
| what are the "psychosocial" theories of aging? |
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Definition
• Maslow's theory: Self-actualization and the evolution of developmental needs occur as the individual ages.
• Disengagement theory: Mutual withdrawal occurs between the aging person and others.
• Activity theory: Actions, roles, and social pursuits are important for satisfactory aging.
• Continuity theory: Life satisfaction and activity are expressions of enduring personality traits. |
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Term
| The major roles of the nurse in terms of milieu management are what? |
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Definition
| to assist the patient in adjusting to the environment, keep the patient safe at all times (e.g., make sure roommates are compatible, call lights are within reach, patients at risk for falling are placed close to the nurses’ station), minimize the adverse effects of hospitalization on functional capacity (e.g., encourage patients to walk as often as they can) |
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Term
| Patient Self-Determination Act of 1990 declared what? |
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Definition
| that nursing-home residents have the right to be free from unnecessary drugs and physical restraints. |
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Term
| What are The requirements governing the use of restraints? |
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Definition
1 Consultation with a physical and/or occupational therapist must be carried out.
2 The least restrictive measures must be considered, and this must be documented.
3 A physician's order is required.
4 Consent of the resident or family must be obtained.
5 Documentation must be provided that the restraint enables the resident to maintain maximum functional and psychological well-being. |
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Term
| what is Partial hospitalization? |
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Definition
| acute psychiatric day hospital programs, are sometimes recommended for ambulatory patients who do not need 24-hour nursing care but require and would benefit from intensive, structured psychiatric treatment. |
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Term
| 3 types of "adult day care" |
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Definition
(1) social day care,
(2) adult day health or medical treatment programs
(3) maintenance day care. |
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Term
1 The nurse is caring for an older adult patient. Which symptom should the nurse recognize as a normal part of aging?
1 Depression
2 Memory loss
3 Situational grieving
4 Delirium |
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Definition
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Term
2 The nurse is caring for a patient experiencing delirium. Which nursing response is appropriate when the patient's daughter asks, “Will he ever stop acting like this?”
1 “I'm sorry, your father will likely be in this state from now on.”
2 “Once we know the cause of the delirium, we can begin treatment to attempt to reverse the process.”
3 “Delirium is caused by infections and electrolyte imbalances, and the damage is permanent.”
4 “A benzodiazepine will help alleviate the delirium.” |
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Definition
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Term
3 A patient with dementia exhibits difficulty feeding himself despite the fact that there is nothing wrong with his motor functions. Which term should the nurse use to document this finding?
1 Aphasia
2 Apraxia
3 Agnosia
4 Disinhibition |
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Definition
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Term
4 An older adult patient experiencing pain states that she is going to use kava kava, which she has heard provides pain relief. Which nursing response is appropriate?
1 “Kava kava is an appropriate herb to use for pain relief.”
2 “Older adults should not use herbal preparations.”
3 “Willow bark would be a better herbal supplement to use.”
4 “Are you using any other treatments for pain relief?” |
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Definition
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Term
5 The nurse is caring for a patient who is a “DNR-CCO.” Which nursing action would be appropriate if the patient were to go into cardiac arrest?
1 Immediately call for the code team
2 Prepare for intubation by physician
3 Administer morphine for pain control
4 Initiate cardiopulmonary resuscitation |
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Definition
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